NPIMap

Organization Active NPI

Radiology Consultants of Washington, Inc., P.S.

  • Diagnostic Radiology Physician
  • Kirkland, WA
National Provider Identifier
1124046057
Registry record updated Sep 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
RADIOLOGY CONSULTANTS OF WASHINGTON, INC., P.S.
Practice address
12112 115TH Ave NE Ste B
Kirkland, WA 98034-6958
Phone
(425) 821-3472
Fax
(425) 820-4115
NPI assigned
Jul 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Shane E. Macaulay, M.D.NPI 1255353710
Title
President
Phone
(425) 821-3472

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

12112 115TH Ave NE Ste B
Kirkland, WA 98034-6958

Mailing address

PO Box 94624
Seattle, WA 98124-6924
Phone (425) 821-3472

Other identifiers 1

IdentifierTypeStateIssuer
7044795MedicaidWA

Other names 1

  • RAYUS Radiology Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, ID2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040302000774 WA Part B Supplier - Clinic/Group Practice 6608763859 Receives reassigned benefits from 19 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Issaquah, WA; Seattle, WA; Renton, WA; Kirkland, WA; Everett, WA; Bellevue, WA
O20240626001683 ID Part B Supplier - Clinic/Group Practice 6608763859 Receives reassigned benefits from 1 practitioner
Practice locations: Worley, ID

National Provider Directory

National Provider Directory
Tax ID family
Radiology Consultants of Washington Inc PS2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1310 116th Ave NE
Ste E
Bellevue, WA 98004
Phone (425) 250-1145

3131 Nassau St
#102
Everett, WA 98201
Phone (425) 740-5000

12112 115th Ave NE
Ste B
Kirkland, WA 98034
Phone (425) 821-3472

12112 115th Ave NE
Kirkland, WA 98034

17910 Talbot Rd S
Ste 103
Renton, WA 98055
Phone (425) 228-4000

115 NE 100th St
Ste 101
Seattle, WA 98125
Phone (206) 524-5599

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 25

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D1097935Rayus Radiology12112 115TH Ave NE Ste B, Kirkland, WA 98034Certificate of waiverApr 4, 2028

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632355200000",
    "number": "1124046057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94624",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981246924",
            "telephone_number": "425-821-3472",
            "fax_number": "425-820-4115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12112 115TH AVE NE STE B",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980346958",
            "telephone_number": "425-821-3472",
            "fax_number": "425-820-4115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIOLOGY CONSULTANTS OF WASHINGTON, INC., P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A",
        "authorized_official_last_name": "MACAULAY",
        "authorized_official_first_name": "SHANE",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-821-3472",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7044795",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RAYUS Radiology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kirkland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.